This is the first in a series of posts that will explain the basics of several new versions of conversion therapy. We will explore how these variations help practitioners avoid some of the negative perceptions connected with the older terminology. They may be able to avoid state bans, appear more legitimate to potential clients, and qualify for insurance reimbursement. Lets start with a few basics.

In the early part of this century, conversion therapy was the popular catchall term covering a host of practices used in an attempt to change one’s sexual orientation from homosexual to heterosexual. The term’s use for this appears to have started circa 1973 and did not, as many who provide these services claim, originate with activists. It is an established term coined by those in the field.

At times it is interchanged with the term reparative therapy®, but this is actually a specific version under the umbrella of conversion therapy. Practitioners dislike this term because it became toxic as people learned more about it. Reparative therapy, a term which is almost as toxic, is the brainchild of the late Dr. Joseph Nicolosi and Elizabeth Moberly. Actually, there is some debate suggesting that Nicolosi appropriated the basic work from Moberly’s writings.

Reparative therapy is the idea that a person missed connecting with the same-sex parent during childhood (that’s the trauma) and to repair that damaged relationship seeks sexual relationships with people of the same sex. Since the person didn’t get love from the same-sex parent, they seek it from peers of the same age or older when they reach puberty. That is the reparative drive seeking to repair the damaged connection between a person and the same-sex parent.

The sources of trauma fall along a wide range of possibilities. A reparative therapist will sift through a client’s history to find something that would count as trauma. Few of us have lives free of what Nicolosi and his fellows would consider trauma. However, if none can be found they will simply claim it is repressed and in need of recovery.

In decades past, the attempts to turn homosexuals into heterosexuals involved much less esoteric practices. Ice-pick lobotomies were used for just about any behavior issue in the 1940s to early 1960s and are technically still legal. This might accomplish the goal by eliminating one’s sex drive entirely, along with other chunks of the person’s personality.

Aversion therapy, where the patient is exposed to negative stimuli (electric shock, emetics) while viewing erotic material of the same sex, was quite popular for many years. It can be somewhat effective but, as with all instances of this technique, the effect does not last. The patient becomes accustomed to the negative stimuli or the association simply wears off.

Electroconvulsive therapy (ECT) was another treatment used heavily for any number of issues from the 1940s to the 1960s. The introduction of psychiatric drugs contributed to its decline. Its use for homosexuality was not effective, but it has experienced a resurgence in the treatment of major depression. It can cause severe memory loss, though it is far less harmful as practiced today.

Hormone treatments, chemical castration, testosterone, and estrogen for women, have all been used at one time or another. Estrogen given to men was to eliminate the sex drive (chemical castration). Testosterone was given under the belief that homosexuality is due to a deficiency. Hormone treatments were given to homosexual women under a similar belief that they suffer from excess testosterone. In one famous case, Alan Turing, the famous British code-breaker, was subject to chemical castration for “gross indecency” and subsequently died of suicide.

Somewhat less severe, though just as ineffective, are hypnosis and psychoanalysis. As with all these practices, however, the underlying premise is that homosexuality is wrong, a disorder in need of a cure. This often leads to great shame and guilt, worsening existing confusion and self-hatred. This can then lead to alcohol and drug abuse, risky behavior, or even suicide. Ironically, this is just what some use to suggest that homosexuals are mentally ill or immoral.

This was the atmosphere surrounding the 1973 decision to remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM). Treating it like a mental illness complete with attempts at a cure had been unsuccessful. There was a growing understanding that homosexuals could lead happy, productive lives like anyone else. The problems many experienced were largely due to the pressures focused from the outside and what that can do to a person’s self-image, along with the internalized hatred and shame mentioned above.

Dr. Robert Spitzer and others led the effort to remove homosexuality as a mental illness. This new way of looking at these issues enabled a number of things to be removed and subsequently considered just variations in the human experience. This made it all the more surprising when a study by Spitzer in 2003 said that change was possible, that people could change their sexual orientation if extremely motivated to do so.

Dr. Robert Spitzer stands in his library viewing a copy of the DSM III.
Dr. Robert Spitzer. Photo from

The study, based solely on self-reported accounts from 200 participants, faced widespread criticism for its flawed methodology and lack of long-term data. In 2012, Spitzer retracted his study and apologized to the LGBTQ+ community, acknowledging the criticisms as valid. His retraction further solidified the medical and psychological consensus that conversion therapy is not only ineffective but also potentially harmful.

You will notice that these practices are overwhelmingly aimed at male homosexuals. One could speculate that this is because men are more visible, or they are more disturbed by these attractions. It may likewise be that women (and society) have fewer issues with their having such feelings. To a lesser degree, some of these same methods have been used with transgender individuals. Focus on them doesn’t ramp up until after the turn of the century and will be covered later in this series.

As the major medical and psychological organizations stopped recognizing homosexuality as a mental illness, organized religion began to take up the mantle. This led to groups like the now defunct Exodus International and many others. This association will also be covered in a follow-up to this basic primer that will flesh out some of the details important to understanding the current state of play surrounding these troublesome practices.

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